Investigating attention toward pain-related cues in an Arabic-speaking population with and without chronic pain

Abstract

There is some evidence for attentional biases in individuals with chronic pain (CP). Cultural and linguistic differences might affect the manifestation of these processes across populations. However, such attentional biases have not been explored in the Arabic-speaking population. The current study investigated these attentional biases and possible associations with resilience. Two matched groups of Arabic-speaking participants with (58) and without (58) CP were recruited from Jordan and the United Kingdom. They completed emotionally modified versions of the Posner cueing and Stroop tasks, alongside questionnaires. Significant group differences were found for the Posner task, with the CP group exhibiting disengagement revealed by the inhibition of return (IOR) effect for sensory pain-related cues compared to delayed disengagement for the other cue types. The control group showed IOR across cue types. No group differences were found on the Stroop task. The CP group had lower resilience scores than healthy controls, and resilience moderated performance on the Posner task. The study provides preliminary evidence about the attentional processes in the Arabic population; the speed of disengagement is affected in the CP group with early disengagement for sensory pain-related information compared to affect pain and neutral stimuli. Furthermore, resilience levels in the CP and control group moderated the performance on the Posner task, suggesting that it influences attentional allocation. This study can help in understanding how the phenomenon of attention bias intertwines with the cultural and linguistic factors. Future research should further explore attentional dynamics across different time points in this population and the modulatory effect of resilience.

Keywords: Arabic population; Attentional bias; Chronic pain; Emotional posner spatial cueing task; Emotional stroop task; Inhibition of return.

Fig. 1

The Arabic version of the modified Posner task; a central fixation (1000 ms), b cue (1000 ms), c target (unlimited time), and d inter-trial interval (500 ms). Participants were told to respond as quickly as possible according to degree of the color of the target box frame (i.e., pressing “up” key for light green and “down” key for dark green)

Fig. 2

The Arabic version of the modified emotional Stroop task, a Sickening, b Fearful, c Dust, and d Throbbing. This shows an example of the temporal progression between randomized trials for word types and color presented. Participants were instructed to identify and respond to the color of the word as quickly as possible

Fig. 3

Mean (standard error of the mean) of the uncued minus cued reaction time difference for the CP and healthy control groups in the sensory, affect, and neutral words conditions. The CP group exhibited IOR only for sensory words, while the control group exhibited IOR (i.e., faster uncued than cued RTs) for all word types